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Primary hyperparathyroidism (1° HPT) is a relatively common endocrine disorder usually caused by autonomous secretion of parathormone by one or several parathyroid adenomas. 1° HPT causing hypercalcemia, kidney stones and/or osteoporosis should be treated whenever possible by parathyroidectomy. Accurate preoperative location of parathyroid adenomas is crucial for surgery planning, mostly when performing minimally invasive surgery. Cervical ultrasonography (US) is usually performed to localize parathyroid adenomas as a first intention, followed by 99mTc- sestamibi scintigraphy with SPECT/CT whenever possible. 4D-CT is a possible alternative to 99mTc- sestamibi scintigraphy. Recently, 18F-fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) has made its way in the clinics as it is the most sensitive method for parathyroid adenoma detection. It can eventually be combined to 4D-CT to increase its diagnostic performance, although this results in higher dose exposure to the patient. Other forms of hyperparathyroidism consist in secondary (2° HPT) and tertiary hyperparathyroidism (3° HPT). As parathyroidectomy is not usually part of the management of patients with 2° HPT, parathyroid imaging is not routinely performed in these patients. In patients with 3° HPT, total or subtotal parathyroidectomy is often performed. Localization of hyperfunctional glands is an important aid to surgery planning. As 18F-FCH PET/CT is the most sensitive modality in multigland disease, it is the preferred imaging technic in 3° HPT patients, although its cost and availability may limit its widespread use in this setting. [ABSTRACT FROM AUTHOR]

Ochroconis gallopava is an anamorphic mould characterized by slow growth rate and production of a maroon pigment, which has been isolated worldwide from soil, thermal springs, decaying vegetation, and chicken litter. It has been reported to cause localized, mostly pulmonary, and systemic infection in severely immunocompromised patients. We describe the case of a 76-year-old woman known for ulcerative colitis-related bronchiectasis treated with low dose oral steroids, who developed a fungal bronchitis with dark, bloody-like, sputum which was initially misinterpreted as haemoptysis. A filamentary mould grew on sputum culture, and was identified by DNA analysis as Ochroconis gallopava . We observed a significant clinical improvement after 6 weeks of itraconazole therapy. [ABSTRACT FROM AUTHOR]

Highlights: [•] Optimization of the throughput (in fact the period that is the inverse of the throughput) by using a polynomial time greedy algorithm that considers different speed levels for the machines of the considered platform. The energy consumption is minimal for the optimal period. [•] Optimization of the energy consumption by using a greedy algorithm too. The configuration that is exhibited reaches the minimal period for the optimal energy configuration. [•] The optimality of the two approaches is proven. [•] Alternative solutions are proposed when constraints occur for the period or the energy. A Pareto front can be computed to the appropriate values of the constraints. [ABSTRACT FROM AUTHOR]

Because of the increasing energy consumption of data centers and their CO 2 emissions, the ANR DATAZERO2 project aims to design autonomous data centers running solely on local renewable energy coupled with storage devices to overcome the intermittency issue. In order to optimize the use of renewable energy and storage devices, a MILP solver is usually in charge of assigning the power to be supplied to the data center. However, in order to reduce the computation time and make the approach scalable, it would be more appropriate to use a polynomial time algorithm. This paper aims at showing and proving that it is possible to provide an optimal power profile via a deterministic algorithm using a binary search approach. Considering the main constraints of the initial problem, numerous experimental results show similar results to those given by the MILP. These promising results encourage us to continue in this direction for proposing an efficient management of the data center power supply that takes uncertainty into account. • Optimal polynomial-time algorithm to supply a green DC with a constant profile. • Optimal polynomial-time algorithm to supply a green DC with a non-constant profile. • Scalable approach to avoid the use of MILP solvers to find optimal solutions. • The solutions presented are the same as those obtained with a MILP solvers. • The approach has been proven to be optimal. [ABSTRACT FROM AUTHOR]

Abstract: This article examines the situation of self-catering accommodation in the light of tourist experience in Switzerland. Swiss tourism is currently declining, and so are traditional forms of accommodation such as hotels. At the same time there is evidence that the demand for self-catering holiday properties is increasing. Yet very little is known about this sector in Switzerland. The present paper attempts to identify the number of Swiss self-catering properties and presents the results of interviews and an on-line survey, which shed light on this industry and allows the situation in Switzerland to be compared with that in other countries. The number of holiday homes in Switzerland has increased steadily since the 1980s, and could provide a valuable source of rented property and local income. The Swiss self-catering industry is highly seasonal, although rental properties are mostly available all year round. Swiss accommodation is relatively small and expensive, partly because the rent usually includes laundry and other services, not offered in other countries. Owners often rent to offset the cost of upkeep, rather than to make a profit, and this attitude is reflected in the fragmented and rather unprofessional nature of marketing, representation and communications in the sector. A number of recommendations are made for developing the industry, based on the findings. [Copyright &y& Elsevier]

Objective: Intimal hyperplasia is a vascular remodelling process that occurs after a vascular injury. The mechanisms involved in intimal hyperplasia are proliferation, dedifferentiation, and migration of medial smooth muscle cells towards the subintimal space. We postulated that gap junctions, which coordinate physiologic processes such as cell growth and differentiation, might participate in the development of intimal hyperplasia. Connexin43 (Cx43) expression levels may be altered in intimal hyperplasia, and we therefore evaluated the regulated expression of Cx43 in human saphenous veins in culture in the presence or not of fluvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase activity. Methods: Segments of harvested human saphenous veins, obtained at the time of bypass graft, were opened longitudinally with the luminal surface uppermost and maintained in culture for 14 days. Vein fragments were then processed for histologic examination, neointimal thickness measurements, immunocytochemistry, RNA, and proteins analysis. Results: Of the four connexins (Cx37, 40, 43, and 45), we focused on Cx43 and Cx40, which we found by real-time polymerase chain reaction to be expressed in the saphenous vein because they are the predominant connexins expressed by smooth muscle cells and endothelial cells. After 14 days of culture, histomorphometric analysis showed a significant increase in the intimal thickness as observed during the process of intimal hyperplasia. A time-course analysis revealed a progressive upregulation of Cx43 to reach a maximal increase of sixfold to eightfold at both transcript and protein levels after 14 days in culture. In contrast, the expression of Cx40, abundantly expressed in the endothelial cells, was not altered. Immunofluorescence showed a large increase in Cx43 within smooth muscle cell membranes of the media layer. The development of intimal hyperplasia in vitro was decreased in presence of fluvastatin and was associated with reduced Cx43 expression. Conclusions: These data show that Cx43 is increased in vitro during the process of intimal hyperplasia and that fluvastatin could prevent this induction, supporting a critical role for Cx43-mediated gap-junctional communication in the human vein during the development of intimal hyperplasia. Clinical Relevance: Stenosis due to intimal hyperplasia is the most common cause of failure of venous bypass grafts. To better understand the development of intimal hyperplasia, we used an ex vivo organ culture model to study saphenous veins harvested from patients undergoing a lower limb bypass surgery. In this model, the morphologic and functional integrity of the vessel wall is maintained and significant intimal hyperplasia development occurs after 14 days in culture. We have postulated that gap junctions, which coordinate physiologic processes such as cell growth and differentiation, may participate in the development of intimal hyperplasia. Indeed, intimal hyperplasia consists of proliferation and migration of smooth muscle cells into the subendothelial space. Intercellular communication is responsible for the direct transfer of ions and small molecules from one cell to the other through gap-junction channels found at cell-cell appositions. No study to date has evaluated whether gap junctional communication is involved in the process of intimal hyperplasia in humans. This assertion was investigated by using the aforementioned organ culture model of intimal hyperplasia in human saphenous veins, and our data support a critical role for Cx43-mediated gap junctional communication in human vein during the development of intimal hyperplasia. [Copyright &y& Elsevier]

• We tackle the task scheduling with power constraint problem. • We prove the complexity of most instances of this problem. • We propose heuristics to address the problem. • We provide a performance comparison of these heuristics. The energy consumption of large Information and Communications Technology structures such as data and computation centers along with the corresponding carbon footprint are on the rise. Green computing has become an indispensable solution to face the resulting economical and environmental challenges. Powering these centers with renewable energy sources is however a challenge since these sources cannot guarantee a constant power supply due to their fluctuating power production. We here tackle the problem of scheduling independent tasks on a multi-core machine within a predicted renewable power envelope that varies over time. We evaluate the complexity of different instances of the problem from a theoretical point of view. We propose several heuristics, including genetic algorithms, and we conduct experiments to assess their performance. For some particular cases we compare the performance of these heuristics to optimal solutions. [ABSTRACT FROM AUTHOR]

• Both IT and power supply sizing for an on-site standalone data center. • Optimal IT sizing algorithm and proved as such, depending on the given workload (tasks and services). • Sizing algorithm to compute a set of green power supply infrastructures consisting of wind turbines, solar panels, batteries and hydrogen system. • Comprehensive experiments to discuss the obtained solutions and justify the influences of different parameters on the data center sizing. • Discussion on the influences of different parameters to help decision maker for choosing the appropriate design of his data center depending on his context, workload and location. In this work, we propose a two-step methodology for designing and sizing a data center solely powered by local renewable energy. The first step consists in determining the necessary IT equipment for processing a given IT workload composed of batch and service tasks. We propose an adapted binary search algorithm and prove its optimality to find the minimum number of servers to handle the IT workload. When the IT sizing is computed, the second step consists in defining the supplying electrical infrastructure using wind turbines and photovoltaic panels as primary sources. Batteries and a hydrogen system are added as secondary sources for short- and long-term energy storage, respectively. In this electrical sizing step, first a set of primary source configurations is determined using a binary search algorithm, then the secondary sources are calibrated so that levels of charge are constant during one day and one year, respectively. Experiments using real IT workload traces and actual meteorological data are conducted to illustrate the provided methodology to decision makers for choosing the best configuration for their data center. [ABSTRACT FROM AUTHOR]

Airway stenting is a common endoscopie procedure that is used to treat a variety of central airway lesions. Obstructions or fistulas involving the carina or nearby tracheo-bronchial structures require the use of specially designed stents, commonly referred to as Y-stents. Conventional methods of endobronchial Y-stent delivery are all characterized by a blind and apneic period during the procedure that carries the risk of stent misplacement or ventilation/oxygeation problems or both. Using combined suspension laryngoscopy, flexible bronchoscopy, and jet ventilation, we describe a technique that makes challenging bronchoscopic interventions--such as self-expandable Y-shaped airway stent delivery--easy, precise, and safe. [ABSTRACT FROM AUTHOR]

Allergic skin inflammation often presents in early childhood; however, little is known about the events leading to its initiation and whether it is transient or long-term in nature. We sought to determine the immunologic rules that govern skin inflammation in early life. Neonatal and adult mice were epicutaneously sensitized with allergen followed by airway allergen challenge. Epicutaneous application of labeled allergen allowed for determination of antigen uptake and processing by antigen-presenting cells. RNAseq and microbiome analysis was performed on skin from neonatal and adult specific pathogen-free and germ-free mice. A mixed T H 2/T H 17 inflammatory response in the skin and the lungs of adult mice was observed following sensitization and challenge. Comparatively, neonatal mice did not develop overt skin inflammation, but exhibited systemic release of IL-17a and a T H 2-dominated lung response. Mechanical skin barrier disruption was not sufficient to drive allergic skin inflammation, although it did promote systemic immune priming. Skin of neonatal mice and adult germ-free mice was seeded with low numbers of antigen-presenting cells and impaired chemokine and alarmin production. Enhanced chemokine and alarmin production, and seeding of the skin with antigen-presenting cells capable of instructing recruited cells to elicit their effector function, was, at least in part, dependent on formation of the microbiome, and consequently contributed to the development of overt skin disease. These data shed light on the principles that underlie allergic inflammation in different tissues and highlight a window of opportunity that might exist for early-life prevention of allergic diseases. [ABSTRACT FROM AUTHOR]

Background Homeostatic turnover of the extracellular matrix conditions the structure and function of the healthy lung. In lung transplantation, long-term management remains limited by chronic lung allograft dysfunction, an umbrella term used for a heterogeneous entity ultimately associated with pathological airway and/or parenchyma remodeling. Objective This study assessed whether the local cross-talk between the pulmonary microbiota and host cells is a key determinant in the control of lower airway remodeling posttransplantation. Methods Microbiota DNA and host total RNA were isolated from 189 bronchoalveolar lavages obtained from 116 patients post lung transplantation. Expression of a set of 11 genes encoding either matrix components or factors involved in matrix synthesis or degradation (anabolic and catabolic remodeling, respectively) was quantified by real-time quantitative PCR. Microbiota composition was characterized using 16S ribosomal RNA gene sequencing and culture. Results We identified 4 host gene expression profiles, among which catabolic remodeling, associated with high expression of metallopeptidase-7, -9, and -12, diverged from anabolic remodeling linked to maximal thrombospondin and platelet-derived growth factor D expression. While catabolic remodeling aligned with a microbiota dominated by proinflammatory bacteria (eg, Staphylococcus , Pseudomonas, and Corynebacterium ), anabolic remodeling was linked to typical members of the healthy steady state (eg, Prevotella , Streptococcus, and Veillonella ). Mechanistic assays provided direct evidence that these bacteria can impact host macrophage-fibroblast activation and matrix deposition. Conclusions Host-microbes interplay potentially determines remodeling activities in the transplanted lung, highlighting new therapeutic opportunities to ultimately improve long-term lung transplant outcome. [ABSTRACT FROM AUTHOR]

Lung-volume reduction using coils is an effective and safe treatment for selected patients presenting severe emphysema and hyperinflation. Most complications occur during the first 30 days after the procedure. Although frequent, hemoptysis is usually transient and minor. Antiaggregation therapy is common in patients with emphysema who, very often, have additional tobacco-associated comorbidities. Aspirin is considered safe for most major interventions; however, clopidogrel is mainly contraindicated and considered an exclusion criterion. We present a case of life-threatening hemoptysis caused by dual antiaggregation therapy “accidentally” introduced 3 months after the procedure. So far no recommendations exist on the optimal therapeutic strategy after lung-volume reduction with coils. [ABSTRACT FROM AUTHOR]

We describe a patient with cystic fibrosis, end-stage lung disease, and secondary pulmonary hypertension in whom aerosolized iloprost was effective in lowering pulmonary artery pressure and improving functional status, thus proving successful as a bridge to lung transplantation. Inhaled iloprost may be an efficient and selective approach to treat pulmonary hypertension related to end-stage obstructive pulmonary disease. [Copyright &y& Elsevier]

Abstract: The c-Jun N-terminal kinase (JNK) is a mitogen-activated protein kinase (MAPK) activated by stress-signals and involved in many different diseases. Previous results proved the powerful effect of the cell permeable peptide inhibitor d-JNKI1 (d-retro-inverso form of c-Jun N-terminal kinase-inhibitor) against neuronal death in CNS diseases, but the precise features of this neuroprotection remain unclear. We here performed cell-free and in vitro experiments for a deeper characterization of d-JNKI1 features in physiological conditions. This peptide works by preventing JNK interaction with its c-Jun N-terminal kinase–binding domain (JBD) dependent targets. We here focused on the two JNK upstream MAPKKs, mitogen-activated protein kinase kinase 4 (MKK4) and mitogen-activated protein kinase kinase 7 (MKK7), because they contain a JBD homology domain. We proved that d-JNKI1 prevents MKK4 and MKK7 activity in cell-free and in vitro experiments: these MAPKK could be considered not only activators but also substrates of JNK. This means that d-JNKI1 can interrupt downstream but also upstream events along the JNK cascade, highlighting a new remarkable feature of this peptide. We also showed the lack of any direct effect of the peptide on p38, MEK1, and extracellular signal-regulated kinase (ERK) in cell free, while in rat primary cortical neurons JNK inhibition activates the MEK1–ERK–Ets1/c-Fos cascade. JNK inhibition induces a compensatory effect and leads to ERK activation via MEK1, resulting in an activation of the survival pathway—(MEK1/ERK) as a consequence of the death pathway—(JNK) inhibition. This study should hold as an important step to clarify the strong neuroprotective effect of d-JNKI1. [Copyright &y& Elsevier]

Renin secretion is regulated by coordinated signaling between the various cells of the juxtaglomerular apparatus. The renin-secreting cells (RSC), which play a major role in the control of blood pressure, are coupled to each other and to endothelial cells by Connexin40 (Cx40)-containing channels. In this study, we show that Cx40 knockout (Cx40−/−) mice, but not their heterozygous littermates, are hypertensive due to the increase in the number of RSC, renin biosynthesis, and plasma renin. Treatment with the angiotensin II receptor AT1 antagonist candesartan or the angiotensin II-converting enzyme inhibitor ramipril reduced the blood pressure of the Cx40−/− mice to the same levels seen in wild-type (WT) mice. The elevated blood pressure of the knockout mice was not affected by clipping one renal artery (2K1C, renin-dependent model of hypertension) or after a high salt diet. Under these conditions, however, Cx40−/− mice showed an altered production and release of renin. The renin mRNA ratio between the clipped and the non-clipped kidney was lower in the knockout than in the WT 2K1C mice. This indicates that the response to a change in blood pressure was altered. The RSC of the Cx40−/− mice did not have a compensatory increase in the levels of either Cx43 or Cx37. Our data show that renin secretion is dependent on Cx40 and suggest the Cx40−/− mice may be a genetic model of renin-dependent hypertension.Kidney International (2007) 72, 814–822; doi:10.1038/sj.ki.5002423; published online 11 July 2007 [ABSTRACT FROM AUTHOR]